Lentzaris Dimitrios, Gkrozou Fani, Skentou Chara, Koutalia Nikoleta, Bais Vasileios, Vatopoulou Anastasia, Paschopoulos Minas
Obstetrics and Gynaecology, University Hospital of Ioannina, Ioannina, GRC.
Cureus. 2025 Mar 26;17(3):e81215. doi: 10.7759/cureus.81215. eCollection 2025 Mar.
Endometriosis is a gynaecological condition affecting reproductive-age women. In case of ovarian endometriosis, there is cystic formation, called endometrioma. Although laparoscopic cystectomy is established as the gold standard for the treatment of endometriomas, it is related to damage of healthy ovarian tissue and significant decrease in ovarian reserve. As a result, new strategies have been set for the care of endometriomas, with ethanol sclerotherapy as the most popular alternative. As a part of sclerotherapy, ethanol solution is injected to destroy pseudocapsule. Iatrogenic damage is minimized, making it a safe and less invasive technique. In this study, we compared ultrasound-guided (U/S) ethanol sclerotherapy and laparoscopic ethanol sclerotherapy with laparoscopic cystectomy. Anti-Müllerian hormone (AMH) is used to monitor ovarian preservation. Sclerotherapy seems to have smaller effect on ovarian reserve compared to cystectomy. Recurrence rate and clinical pregnancy rate are similar, though cystectomy has better outcome of symptom relief. Moreover, laparoscopic sclerotherapy seems to achieve the best clinical pregnancy rate and decrease recurrence rate.
子宫内膜异位症是一种影响育龄女性的妇科疾病。在卵巢子宫内膜异位症的情况下，会形成囊肿，称为子宫内膜异位囊肿。尽管腹腔镜囊肿切除术已被确立为治疗子宫内膜异位囊肿的金标准，但它会对健康的卵巢组织造成损伤，并导致卵巢储备显著下降。因此，已经为子宫内膜异位囊肿的治疗制定了新策略，乙醇硬化疗法是最受欢迎的替代方法。作为硬化疗法的一部分，注入乙醇溶液以破坏假包膜。医源性损伤降至最低，使其成为一种安全且侵入性较小的技术。在本研究中，我们将超声引导下（U/S）乙醇硬化疗法和腹腔镜乙醇硬化疗法与腹腔镜囊肿切除术进行了比较。抗苗勒管激素（AMH）用于监测卵巢保留情况。与囊肿切除术相比，硬化疗法对卵巢储备的影响似乎较小。复发率和临床妊娠率相似，不过囊肿切除术在症状缓解方面效果更好。此外，腹腔镜硬化疗法似乎能达到最佳的临床妊娠率并降低复发率。
